Autopsy of Drug-induced Lung Injury with Atypical Diffuse Alveolar Disorder due to Amiodarone: A Case Report

Hikaru Mamizu; Hiroki Kohda; Yuusuke Tomita; Takuma Hatakeyama; Maiko Mamizu; Daisuke Ishikawa; Hidenori Kawakami; Toshiki Furukawa; Takashi Ishida; Tsuyoshi Sakai

doi:10.2169/internalmedicine.3141-23

Hikaru Mamizu, Hiroki Kohda, Yuusuke Tomita, Takuma Hatakeyama, Maiko Mamizu, Daisuke Ishikawa, Hidenori Kawakami, Toshiki Furukawa, Takashi Ishida, Tsuyoshi Sakai

Author information

Hikaru Mamizu
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Hiroki Kohda
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Yuusuke Tomita
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Takuma Hatakeyama
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Maiko Mamizu
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Daisuke Ishikawa
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Hidenori Kawakami
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Toshiki Furukawa
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Takashi Ishida
Department of Internal Medicine, Niigata Prefectural Central Hospital, Japan
Tsuyoshi Sakai
Department of Diagnostic Pathology, Niigata Prefectural Central Hospital, Japan

Keywords: amiodarone, acute fibrinous and organizing pneumonia, drug-induced lung injury, diffuse alveolar damage, fibrin deposition

JOURNAL OPEN ACCESS Advance online publication

Article ID: 3141-23

DOI https://doi.org/10.2169/internalmedicine.3141-23

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Abstract

Amiodarone, a prominent antiarrhythmic drug, may cause lung injury. We herein report the case of an 87-year-old man who had been taking amiodarone for 5 years and was subsequently referred due to respiratory failure. Chest computed tomography revealed multiple consolidations with air bronchograms in both lungs. Despite administering steroid pulse therapy, his respiratory failure worsened, and he died 3 days later. Autopsy revealed hyaline membrane formation and organic formation with fibrin deposition. Drug-induced lung injury caused by amiodarone was confirmed by autopsy. Caution is therefore required when fibrin deposition in the alveolar spaces is observed in such cases, which are prone to suffer a rapid deterioration.

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